Blood transfusion
Facility: Fredonia Regional Hospital
Billing Code: 36430 (CPT)
- CPT Billing Code: 36430
- Insurance Median: $484
- Cash Discount Price: $754
- vs. Medicare Baseline: 1.07x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $450.73 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $70 - $516 | 16% |
| UnitedHealthcare | $72 - $875 | 16% |
| Veterans Programs - All Plans | $72 - $496 | 16% |
| Aetna | $72 - $875 | 16% |
| Meritain-All Plans | $127 - $875 | 28% |
| Reserve National-All Plans | $127 - $875 | 28% |
| Cigna | $127 - $875 | 28% |
Consumer Guidance & Cost Commentary
For the CPT code 36430 (Blood transfusion) at Fredonia Regional Hospital in Fredonia, KS, the cash price is $754.00, which matches the facility's median paid amount. While the hospital is a Critical Access Hospital owned by the local government, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. For instance, UnitedHealthcare and Aetna have negotiated ranges extending up to $875, which is higher than the cash rate. This dynamic suggests that patients with high-deductible plans might save money by paying the cash price directly, provided they have the funds available, as the insurance allowed amounts in this dataset frequently surpass the self-pay rate.
To minimize unexpected costs, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling services, as these upfront payment incentives can reduce the final bill by 20% to 50%. Furthermore, if you are using out-of-network insurance or receive care from providers without a contract, you may face balance billing for the difference between the provider's full charge and what your insurer pays. It is crucial to request a detailed, itemized bill to verify that no services were unbundled or charged twice, as over 80% of hospital bills contain errors. Finally, when evaluating the facility's pricing, compare the rates against the Medicare benchmark of $450.73 rather than the inflated chargemaster list; the commercial negotiated rates here average significantly higher than this federal baseline, highlighting the importance of understanding the true cost versus the listed price.